Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2013, vol. 22, nr 1, January-February, p. 125–130

Publication type: review article

Language: English

Safety and Current Achievements in Thyroid Surgery with Neuromonitoring

Bezpieczeństwo i najnowsze osiągnięcia w chirurgii tarczycy z użyciem neuromonitoringu

Paweł Domosławski1,A,B,C,D, Tadeusz Łukieńczuk1,E,F, Krzysztof Kaliszewski1,E,F, Krzysztof Sutkowski1,E,F, Romualda Wojczys1,E,F, Beata Wojtczak1,E,F

1 1st Department and Clinic of General, Gastroenterological and Endocrinological Surgery, Wroclaw Medical University, Poland

Abstract

One of the most important complications during thyroid surgery is injury of the recurrent laryngeal nerve (RLN) which leads to dysfunction and palsy of the vocal folds. Adequate knowledge about the location of the RLN supported by neuromonitoring can help the operating surgeon to prevent this complication. Visualisation of the nerve alone seems to not be enough. Much more important is an estimation of the function of the RLN. One can say that nowadays we are in the passing era (transition period) of only visualisation of the recurrent laryngeal nerve during operation and entering the era of its neuromonitoring. Neuromonitoring gives us information about the location and function of the RLN. Using this equipment, thyroid surgery becomes safer not only for the patients but also for the operating surgeon in the way of the medicolegal consequences of surgical complications.

Streszczenie

Jednym z najpoważniejszych powikłań operacji gruczołu tarczowego są uszkodzenia nerwu krtaniowego wstecznego (NKW), prowadzące do porażeń fałdów głosowych. Chirurg, mając odpowiednią wiedzę o położeniu NKW, wspomaganą przez neuromonitoring, może zapobiec temu powikłaniu. Dotychczasowe metody wizualizacji nerwu krtaniowego wstecznego okazały się niewystarczające. Ważnym czynnikiem jest określenie funkcji nerwu podczas zabiegu chirurgicznego. Można więc przyjąć, że obecnie trwa okres przejściowy między erą tylko wizualizacji nerwu krtaniowego wstecznego podczas operacji a nadchodzącą erą jej neuromonitoringu. Neuromonitoring dostarcza informacji o położeniu i funkcji NKW. Chirurgia tarczycy z zastosowaniem sprzętu do neuromonitoringu jest bardziej bezpieczna nie tylko dla pacjenta, ale i dla operującego chirurga, biorąc pod uwagę pozabiegowe prawne następstwa powikłań.

Key words

recurrent laryngeal nerve, neuromonitoring, thyroid surgery.

Słowa kluczowe

nerw krtaniowy wsteczny, neuromonitoring, chirurgia tarczycy.

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